A Clinicopathological Study of Necrotizing Fasciitis
نویسندگان
چکیده
Background: Necrotizing fasciitis is a relatively common infection with high morbidity and mortality, as they often present late in their clinical course. Quick and aggressive surgical treatment improves survival and decreases hospital stay. Methods: A prospective study of 50 consecutive patients of necrotizing fasciitis who were admitted in our hospital over a period of 342 days between May 2007 and April 2008. The study includes clinical presentation, biochemical parameters, bacteriology, predisposing factors, associated co-morbid conditions, time interval between admission and first surgical intervention and outcome of this life threatening infection. Results: 50 patients of necrotizing fasciitis were studied over a period of 342 days. The mean age of the patients were 44.5 ± 8.36 years and male: female ratio was 3.17 : 1. Diabetes mellitus was the most common co-morbid condition (42%). Alcoholism was the commonest addiction (34%). Regarding predisposing conditions majority (48%) of the cases were idiopathic. History of trivial trauma was present in (38%) patients. Mean duration of symptoms was 5.16 ± 0.902 days. Perineum was the commonest site involved (52%) followed by the lower extremity (40%). The commonest bacteria isolated was E.coli (42%). The culture was polymicrobial in (78%) patients. Mean number of surgical debridement were 3.84 ± 0.809. Secondary surgical procedures included mobilization and suturing (48%) and skin grafting (42%). Average duration of hospital stay was 33.04 ± 7.99 days. Mortality was 10%. Conclusions: Necrotizing fasciitis is more common in middle aged males. Diabetes mellitus is the most common co-morbid condition associated with necrotizing fasciitis. The perineum is commonly affected. The presence of multiple comorbid conditions reduces the survival. Early diagnosis and aggressive surgical debridement reduces mortality.
منابع مشابه
Cervicofacial Necrotizing Fasciitis in Patients with No Underlying Medical Conditions: A Review of Four Cases Seen in Twelve Months at a Nigerian Tertiary Hospital
Necrotizing fasciitis of the head and neck is a rare but rapidly progressive infection involving the skin, subcutaneous tissue, and fascia. We report 4 cases of cervicofacial necrotizing fasciitis with similar patterns of presentation. All the 4 cases presented with an odontogenic source and no underlying medical condition. All the patients had tooth extraction and serial wound debridement. Thr...
متن کاملLife –threatening Necrotizing Fasciitis: a case report
Necrotizing fasciitis is characterized by a rapidly progressing necrosis of subcutaneous fat and fascia that rarely occurs in head and neck. It can be life threatening in the case of late diagnosis and antibiotic therapy and without surgical intervention. It is caused by group A streptococci or by a synergistic combination of aerobe and anaerobe microorganisms and bacterial synergy is an import...
متن کاملNecrotizing Fascitis in a 47-Year Old Diabetic Man: Case Report
Necrotizing fasciitis is one of the rare complications of misdiagnosed appendicitis with the mortality rate of over 25%.We report a 47-year old diabetic man admitted with necrotizing fasciitis of flank and abdominal wall secondary to acute appendicitis. The patient, with primary diagnosis of gas gangrene and necrotizing fasciitis, underwent surgical operation and after 3 months, elective append...
متن کاملUnsuspected early necrotizing fasciitis identified by 18F-FDG PET imaging in a patient with acute myeloid leukemia
Necrotizing fasciitis is a part of a spectrum of necrotizing soft tissue infections that usually follow a surgical intervention or a chronic / acute medical illness. Diagnosis is often based on symptoms which classically start within hours after an injury. There are no reports on the use of PET/CT in this condition. Sparing reports of its association in patients with malignancy (Ca of colon and...
متن کامل